Radiology: Trauma Flashcards
(40 cards)
what are the main 4 things you will pick up on a chest XR
- pneumothorax
- pneumonia
- effusion
- pneumoperitoneum
what will you see on a pneumothorax
- dark area at edges
- look for lobe collapse (lobe markings)
tension pneumothorax tx?
- cannula in to treat it
- then CT chest
what will you see with a pneumonia?
- light and white
- hazy type appearance
- infective?
- cancer red flags? could be cancer. repeat chest XR in 6 weeks to see if something underlying it
- sometimes sits against heart border and destroys it
pleural effusion chest XR
- find usually at bottom of the lung
- dense whiteness
- unilateral pleural effusion think cancer
- if bilateral? congestive HF
what do you see in pneumoperitoneum?
- gas under diaphragm
- particularly on right hand side
- double line
- CT and call gen surgeon
(diaphragm is top line, gas in between and liver being pushed up on RS)
first line Ix for suspected bowel perforation
- chest XR (and abdomen)
what are the 2 most likely things to see on abdominal XR in A+E?
- obstruction
- pneumoperitoneum
small bowel vs large bowel perforation
- small bowel is more central and more looped as there is more to it than large bowel
- lots of gas in small but none in large
- next Ix CT
what is a pneumoperitoneum?
presence of free air in the peritoneal cavity
Name different types of fractures
on elbow you can visualise a normal fat pad anteriorly and posteriorly true or false?
false
- just anteriorly
- a visible posterior fat pad can indicate fluid or blood has caused it to rise
what is the anterior sail sign?
- sign used to describe the shape anterior and posterior fat pads make
- suggestive of a radial head fracture
in an elbow of a child what type of fracture would you suspect if both anterior and posterior fat pads are present on XR?
- paediatric supracondylar fracture
if you see a spiral fracture in a child what additional queries would you have?
- NAI
- inform a senior consultant about concerns
how does a colles fracture present?
- extra-articular fracture of distal radius as a result of a FOOSH
- fracture of distal radial metaphyseal region with dorsal angulation
typical risk factor’s for colles fracture
- osteoporotic patient e.g. elderly women
- young person involved in high impact trauma i.e. contact sports, skiing, horse riding
treatment for a colles fracture?
- closed reduction and cast immobilisation
- ORIF is considered when the fracture is unstable or unsatisfactory closed reduction is achieved i.e. >10 degrees dorsal angulation
complication of colles fracture
- malunion = dinner fork deformity
- median nerve palsy and post-traumatic carpal tunnel syndrome
what is a smith’s fracture
- fracture of distal radius w associated volar (palmar) angulation of distal fracture fragments
- considered reverse collest fracture
- occurs after a FOOSH onto a flexed wrist or direct blow to back of wrist
tx of a smith’s fracture
- closed reduction and cast application
- if fracture can be reduced but remains unstable, ORIF is required
complications of a scaphoid fracture?
- blood supply to scaphoid is retrograde so at risk of AVN
different types of NOF fractures?
- intracapsular
- subtrochanteric
- trochanteric
why does AVN occur to femoral head after NOF fracture?
as the major blood supply to femoral head comes from femoral and profunda aa
- NOF can cut this blood supply risking AVN to femoral head
